Method and apparatus for reduction of spondylolisthesis involving the insertion of an elongate implant which is split longitudinally into two side-by-side members, one of which is movable relative to the other, into the disk space between two misaligned vertebrae. Each of the members is provided with teeth for engaging the adjacent vertebrae and positioned on the members so as to be located on opposite sides of the implant. The implant formed by the two side-by-side members is generally rectangularly-shaped in cross section, the height of the rectangularly-shaped cross section being less than the width so that the implant can be inserted between the adjacent vertebrae with the lesser, height dimension oriented in the same direction as the axis of the spinal column and the larger width dimension at approximately a right angle to that axis. One of the two members is then moved relative to the other from the first position in which the members are in the abovedescribed, side-by-side relationship along the longitudinal axis of the implant to a second position in which the members are aligned with the respective, adjacent, misaligned vertebrae and the implant is then rotated by approximately 90° to cause the teeth to contact the bodies of the adjacent vertebrae. The two members are then brought back into the first side-by-side relationship to draw the misaligned vertebrae into alignment and the implant is rotated approximately 90° to disengage the teeth from the vertebrae for removal of the implant from the disk space.

Patent
   5697977
Priority
Mar 18 1994
Filed
Jun 07 1995
Issued
Dec 16 1997
Expiry
Dec 16 2014
Assg.orig
Entity
Small
257
9
EXPIRED
1. A method of aligning adjacent vertebrae after removing a portion of the intervertebral disk from therebetween to form a disk space comprising the steps of:
inserting an elongate body having means formed on opposite sides thereof for selectively engaging the vertebrae adjacent the disk space into the disk space, the body being comprised of first and second side-by-side members, with the vertebrae engaging means extending into the disk space without engaging the adjacent vertebrae;
moving the second member relative to the first member until the first and second members are approximately aligned with each of the adjacent vertebrae;
rotating the body approximately 90° to cause the vertebrae engaging means thereon to engage the vertebrae; and
moving the second member relative to the first member to align the vertebrae to which each member is engaged.
8. A method of aligning adjacent vertebrae after removing portions of the intervertebral disk from therebetween to form first and second disk spaces on the sides of the center thereof comprising the steps of:
inserting a first elongate body having means formed thereon for selectively engaging the vertebrae adjacent the disk space into the first disk space, the first body being comprised of first and second side-by-side members;
moving the second member of the first body relative to the first member of the first body to a position in which the first and second members of the first body are approximately aligned with the adjacent vertebrae;
rotating the first body approximately 90° to cause the vertebrae engaging means formed thereon to engage the adjacent vertebrae;
moving the second member of the first body relative to the first member of the first body to align the adjacent vertebrae;
inserting a second elongate body having means formed thereon for selectively engaging the adjacent vertebrae into the second disk space, the second implant being comprised of first and second side-by-side members;
moving the second member of the second body relative to the first member of the second body to a position in which the first and second members of the second body are approximately aligned with the adjacent vertebrae;
rotating the second body approximately 90° to cause the vertebrae engaging means formed thereon to engage the adjacent vertebrae; and
moving the second member of the second body relative to the first member of the second body to align the adjacent vertebrae.
2. The method of claim 1 wherein the first and second members are moved by moving a mandrel to which the second member is mounted.
3. The method of claim 1 wherein the body is elongate and wider in the middle portion than at the ends thereof and the first and second members are aligned with the adjacent vertebrae by positioning at the point relative to the adjacent vertebrae at which the respective wider middle portions maximally engage the respective adjacent vertebrae.
4. The method of claim 1 wherein the body is substantially rectangularly-shaped in cross section, the sides of the body defining a height of smaller dimension than the dimension of the sides defining the width of the body, the vertebrae engaging means being formed on the sides of the body defining the height thereof.
5. The method of claim 1 wherein the body is inserted into the disk space on one side of the center of the adjacent vertebrae.
6. The method of claim 1 additionally comprising replacing the first body with a monolithic implant after aligning the adjacent vertebrae.
7. The method of claim 6 additionally comprising replacing the second body with a second monolithic implant.
9. The method of claim 8 wherein the first and second members of the first and second bodies are moved by moving a mandrel to which the respective second members are mounted.
10. The method of claim 8 wherein the first and second elongate bodies are wider in the respective middle portions than at the ends thereof.
11. The method of claim 8 wherein the first and second elongate bodies are substantially rectangularly-shaped in cross section, the sides of the respective bodies defining the height being of smaller dimension than the dimension of the sides defining the width of the respective bodies, and the vertebrae engaging means are formed on the sides of the respective bodies defining the height thereof.

The present application is a continuation-in-part of the International Application No. PCT/US95/03374, entitled MIDDLE EXPANDED, REMOVABLE, INTERVERTEBRAL DISK IMPLANT AND METHOD OF LUMBAR INTERVERTEBRAL DISK STABILIZATION, filed on Mar. 17, 1995. When filed in the U.S., that National Phase application will itself be a continuation-in-part of U.S. application Ser. No. 08/210,229, filed Mar. 18, 1994 and having that same title.

The present invention relates to a method and apparatus for reduction of spondylolisthesis, e.g., misalignment of the vertebrae comprising the spinal column. More specifically, the present invention relates to an apparatus which is inserted into the disk space between two adjacent, misaligned vertebrae, engages the bodies of the adjacent vertebrae, and pulls the adjacent vertebrae back into alignment and a method utilizing that apparatus.

Treatment of disorders of the spinal column, especially in the cervical and lumbar regions, continues to be a challenging field of medicine. Classical treatments for conditions involving subluxation of one vertebrae upon another, resulting in misalignment of the spinal column, involve the use of screws which extend through a plate and which are tightened to draw the misaligned vertebrae back into alignment. However, such conditions often involve damage to the intervertebral disk, e.g., rupture or herniation, which may result in compression of a nerve root. If the herniation is large, compression may be bilateral. This condition is usually not corrected by re-aligning the vertebrae with a plate and screws such that surgical removal of the disk followed by fusion is often indicated after reduction of spondylolisthesis.

However, diskectomy with fusion is not ideal because the replaced bone does not have the function of the cartilaginous tissue of the disk, i.e. no cushioning effect, and has complications because of several factors. First, conventional bone plugs used to pack the disk space do not conform to the space of the disk because the disk bulges maximally in the center. The disk space is wider in the middle and narrower at its anterior and posterior ends. For this reason, the various bone plugs which are currently available commercially have only four contact points, i.e. at the front and back of the disk space. Secondly, access to the disk is from the side of the dorsal spine of the adjacent vertebrae, leaving a space that is "off-center" relative to the bodies of the adjacent vertebrae such that the stability of the implant is even more problematical than might be apparent from the limited contact resulting from the shape of the intervertebral space. Another complication is the possibility of infection or other conditions which may require the removal of the implant. Also, if the bone pieces do not fuse, they may eventually extrude out of the disk space, causing pressure on the nerve roots.

Various prosthetic disk plugs, or implants, are disclosed in the art, but all are characterized by limitations of not conforming to the shape of the disk space, lack of stability when inserted off-center, inability to be removed, or other disadvantages. For instance, U.S. Pat. No. 4,863,476 (and its European counterpart, EP-A-0260044) describes an elongated body divided longitudinally into two portions having a cam device movable therebetween for increasing the space between the two body portions once inserted into the disk space. However, that device is generally cylindrical in shape such that the only contact points between the device and the vertebral bodies are at the front and back of the disk space, creating increased likelihood of instability and generally rendering that device unsuitable for use after partial diskectomy. The art also discloses intervertebral disk prostheses (e.g., U.S. Pat. Nos. 3,867,728, 4,309,777, 4,863,477 and 4,932,969 and French Patent Application No. 8816184) which may have more general contact with the adjacent disks, but which are not intended for use in fusion of the disks. The art also includes spinal joint prostheses such as is described in U.S. Pat. No. 4,759,769, which is again not indicated for use when fusion is the preferred surgical intervention.

There is, therefore, a need for an improved method of treatment of conditions involving misalignment of the vertebrae of the spinal column, or spondylolisthesis, and it is a principal object of the present invention to provide such a method and an apparatus for use in connection with that method.

This need is met in the present invention by providing an apparatus for aligning vertebrae comprising an elongate handle having a longitudinal bore therethrough, an implant comprised of first and second side-by-side members, the first member being integrally mounted to the handle and the second member being movable relative to the first member in the direction of the longitudinal axis of the handle, and means formed on opposite sides of the implant for selectively engaging adjacent vertebrae to prevent relative movement between the respective first and second members and the adjacent vertebrae. A mandrel is positioned in the bore in the handle and is connected to the second member for moving the second member relative to the first member in the direction of the longitudinal axis of the handle. To facilitate precise movement of the second member relative to the first, and to confer the mechanical advantage on that movement Which may be required to draw the adjacent vertebrae into alignment, the mandrel is preferably threaded and the bore in the handle is provided with a matching set of threads such that rotation of the mandrel causes movement of the second member along the longitudinal axis of the handle.

In a second aspect, the present invention involves a method of aligning adjacent vertebrae after removing a portion of the intervertebral disk from therebetween to form a disk space comprising the steps of inserting an elongate implant having means formed on opposite sides thereof for selectively engaging the vertebrae adjacent the disk space into the disk space, the implant being comprised of first and second side-by-side members, with the vertebrae engaging means extending into the disk space without engaging the adjacent vertebrae and moving the second member relative to the first member until the first and second members are approximately aligned with the adjacent vertebrae. The implant is rotated by approximately 90° to cause the vertebrae engaging means formed thereon to engage the vertebrae and the second member is then moved relative to the first member to align the vertebrae to which it is engaged with the vertebrae to which the first member is engaged. In the preferred embodiment of the method of the present invention, the disk is removed on both sides of the center line of the spine and a second implant, identical to the first, is inserted between the adjacent vertebrae on the side of the disk space opposite the first implant and the misaligned vertebrae are then drawn back into alignment by simultaneous movement of the second members of both implants. One of the two implants is then removed and replaced with a monolithic implant having roughly the same size and shape while the vertebrae are held in alignment by the other implant. After replacement of one implant with a first monolithic implant, the other implant is replaced with a second monolithic implant.

FIG. 1 is a longitudinal, partial sectional view of a preferred embodiment of the apparatus of the present invention.

FIG. 2 is an end view of the apparatus of FIG. 1.

FIG. 3 is a view similar to that of FIG. 1 but with the mandrel removed therefrom.

FIG. 4 is an end view of the apparatus of FIG. 3.

FIG. 5 is a side, elevational view of the mandrel of the present invention after removal from the apparatus of FIG. 1.

FIG. 6 is an end view of the mandrel of FIG. 5.

FIG. 7 is a partially schematic, lateral view of a portion of the lumbar spine showing the use of the apparatus of FIG. 1 to align the fourth and fifth lumbar vertebrae.

FIG. 8 is an exploded, perspective view of a monolithic implant for use in accordance with the method of the present invention.

FIG. 9 is a lateral view of the fourth and fifth lumbar vertebrae of a human spinal column having the monolithic implant of FIG. 8 inserted therebetween and having a portion of the bodies of the vertebrae shown cut away and/or in shadow lines to show the engagement of the vertebral bodies by the implant.

FIG. 10 is a top, plan view of an alternative embodiment of the apparatus of the present invention showing the two halves of the body in their first, side-by-side position.

FIG. 11 is a top, plan view of the apparatus of FIG. 10 showing the two halves of the body in the second position.

Referring now to the figures, a presently preferred embodiment of an apparatus for aligning adjacent vertebrae constructed in accordance with the teachings of the present invention is shown in FIG. 1. The apparatus, indicated generally at reference numeral 10 is comprised of an elongate handle 11 and an elongate body 12. The body 12 is comprised of first and second side-by-side members 13 and 14, respectively, the first member 13 being integrally mounted to handle 11 and the second member 14 being movable relative to the first member 13 in the direction of the longitudinal axis of the shaft 15 of handle 11.

The shaft 15 of handle 11 is provided with a longitudinal bore 16 therethrough having a mandrel 17 positioned therein, the second member 14 being mounted to mandrel 17. At the end opposite first member 13, the shaft 15 is provided with a tubular barrel 18 having a collar 19 positioned therein. Collar 19 is also provided with a longitudinal bore 16', the longitudinal axis of which is aligned with the longitudinal axis of the bore 16 in mandrel 17 which is provided with a set of threads 20 for receiving the threaded end 21 of mandrel 17. Collar 19 is retained within barrel 18 by the keeper 22 which is retained on the end of barrel 18 by screws 23. An adjustment knob 24 is integrally mounted to collar 18 by screws 26. As a result of this construction, when mandrel 17 is rotated by turning adjustment knob 24, the second member 14 moves relative to first member 13 from a first position in which the members 13 and 14 are in side-by-side, parallel relationship to each other to a second position along the longitudinal axis of the shaft 15 of handle 11 in which the two members remain parallel to each other but are no longer side-by-side as shown in FIG. 7. Referring to FIGS. 3-6, it can be seen that first member 13 is provided with a half round hollow 27 for receiving the round mandrel 17 for retaining the two members 13 and 14 in tight, parallel, side-by-side relationship when second member 14 is moved from the first position to the second position.

When the first and second members 13 and 14 are in the first side-by-side position shown in FIGS. 1 and 2, e.g., when the mandrel 17 is rotated to draw the end 36 of second member 14 against the end 54 of handle 11, the two members 13 and 14 form an elongate body 12 having a shape which is similar to the shape of the monolithic implant 122 shown in FIGS. 8 and 9. Referring, however, to the body 12 for the time being, when side-by-side, the two members 13 and 14 form a body 12 that is comprised of first and second sides 32 and third and fourth sides 34 providing a substantially rectangularly-shaped cross-section. The height H of the rectangularly-shaped cross-section is defined by first and second sides 32 and the width W is defined by the third and fourth sides 34 and, as is apparent by comparison of H and W, the height H of body 12 is less than the width W. As will be explained below, H is minimized to facilitate insertion of the second end 36 into, and positioning of body 12 in, the disk space from which a portion of the intervertebral disk 30 was removed and W is maximized to provide the desired stabilization to adjacent vertebrae 33 and 37. Third and fourth sides 34 are arched from one end of body 12 to the other to provide the portion of body 12 intermediate the ends 25 and 36 with a width W' which is larger than the width W" at the ends 25 and 36. Because the sides 32 of body 12 are substantially flat and the sides 34 are arched from one end 25 to the other end 36, body 12 is described as being a biplanar, bi-convex body. The convex, or arched, sides 34 of body 12 are provided with a plurality of teeth 38 for biting into the adjacent vertebrae 33 and 37 as will be explained in more detail below. The end 36 of body 12 is formed in a blunt, or rounded shape to reduce the likelihood of injury to the nerves of the spinal cord during insertion into the disk space.

Referring now to FIG. 7, the use of the apparatus 10 for reduction of spondylolisthesis is shown. In FIG. 7, the fourth lumbar vertebrae (L4) 33 is shown as having shifted anteriorally, leaving that vertebrae out of alignment with the fifth lumbar vertebrae (L5) 37 and the first vertebrae comprising the sacrum 35. To correct this misalignment, surgery is performed as in a simple diskectomy and the intervertebral disk (not shown) is exposed through a small laminotomy. Disk material is removed and any nerve root compression is corrected. The posterior longitudinal ligament (not shown) and disk cartilage are removed until the surface of the bodies 29 and 31 of the adjacent vertebrae (L4 and L5) 33 and 37, respectively, are exposed above and below the disk space.

Using spreaders such as those disclosed in International Application No. PCT/US 95/03347, which reference is hereby incorporated into this specification in its entirety by this specific reference thereto, the adjacent vertebrae 33 and 37 are distracted to open the disk space. The body 12 of apparatus 10, having the first and second members 13 and 14 initially in the above-described side-by-side relationship, is then inserted into the disk space with the top and bottom thereof, i.e., the first and second substantially planar sides 32, engaging the adjacent vertebrae 33 and 37 so that the teeth 38 formed on the third and fourth sides 34 of body 12 extend into the disk space without engaging the adjacent vertebrae 33 and 37. The implant is oriented in the disk space so that, when rotated as described below, the first member 13 is the portion of the body 12 which contacts the body 31 of L5 37 and the second member contacts the body 29 of L4 33. In other words, body 12 is oriented so that first member 13 is positioned in close proximity to the body 31 of the vertebrae 37 which is aligned with the axis, or centerline, of the spinal column and second member 14 is positioned in close proximity to the body 29 of the vertebrae 33 which is out of alignment. The body 12 of apparatus 10 is inserted until the middle portion of first member 13 is positioned adjacent the concavity in the upper surface of the body 31 of the L5 37. Using the adjustment knob 24, mandrel 17 is then rotated to advance the second member 14, e.g., the portion having the wider width W", anteriorally until the middle portion, e.g., the portion having the wider width W", of second member 14 is positioned adjacent the concavity of the lower surface of the body 29 of L4 33. As noted above, the wider middle portion W" of each of the members 13 and 14 comprising the body 12 of apparatus 10 provides maximal engagement of the concave shaped surface of the body of the vertebrae when the body 12 is rotated by approximately 90° as described below. Those skilled in the art who have the benefit of this disclosure will recognize that, depending upon the circumstances of each surgery, it may also be advantageous to "pre-adjust" the body 12 by advancing the second member 14 to the second position by the amount of the misalignment before inserting the body 12 of apparatus 10 into the disk space and that the mount of slippage of L4 33 relative to L5 37 is calculated using known methods and/or estimated from X-ray films or other images.

Once the first and second members 13 and 14 are approximately aligned with each of the adjacent vertebrae 33 and 37 by positioning the wide, middle portion of each member in the respective concavities of the vertebrae, using the barrel 18 of handle 11, the body 12 of apparatus 10 is rotated by approximately 90° to cause the teeth 38 formed on the surfaces 34 of first and second members 13 and 14 to engage the bodies 29 and 31 of the respective adjacent vertebrae 33 and 37 as shown in FIG. 7. Using the adjustment knob 24, mandrel 17 is then rotated in the opposite direction to draw second member 14 back into the first, side-by-side, parallel relationship with first member 13, pulling the vertebrae to which it is engaged, i.e., L4 33, back into alignment with L5 37.

For reasons which will be made clear by the following description, in a particularly preferred embodiment of the method of the present invention, the diskectomy and laminotomy are performed bilaterally. In other words, the above-described surgical procedure is performed to the side of the center line of the adjacent vertebrae such that the portion of the intervertebral disk which is removed is "off center" relative to the bodies 29 and 31 of the respective adjacent vertebrae 33 and 37. It is preferred that an identical surgery be performed on the other, or second, side of the center line of the adjacent vertebrae and that the body of a second apparatus (not shown in the figures for purposes of clarity) be inserted into the disk space after that procedure. The adjacent vertebrae 33 and 37 are then aligned by rotation of the respective adjustment knobs 24 of both apparatus 10 until the vertebrae are aligned. In this fashion, the body 12 of one of the two apparatus 10 retains the adjacent vertebrae in alignment even after removal of the other implant.

Removal of the body 12 is accomplished by rotation by approximately 90° (preferably in the direction opposite the direction of rotation which was utilized to cause the teeth 38 to engage the respective adjacent vertebrae 33 and 37) so as to disengage the teeth 38 from L4 33 and L5 37. While the body of the second apparatus remains in the disk space on the second side of the center line, the implant 122 (see FIG. 8) is inserted into the disk space from which the first body 12 was removed. Implant 122 is constructed in essentially the same shape as the body 12 of apparatus 10 when both of the first and second members 13 and 14 are in the first, side-by-side, parallel position described above but is monolithic in its construction, i.e., is not split longitudinally in the manner in which the body 12 of apparatus 10 is split into first and second members 13 and 14. Because of the similarity in the shape and component parts of the body 12 and implant 122, it is not necessary to describe the component parts of monolithic implant 122 in further detail other than to note that the corresponding parts of implant 122 are numbered with the same reference numerals but preceded with a "1", e.g., the teeth 38 of body 12 are numbered as 138 on implant 122. Implant 122 and methods for spinal fusion utilizing implant 122 are described in detail in my co-pending application, filed on the same date as the present application Ser. No. 08/475211, entitled ROTATING, LOCKING, MIDDLE-EXPANDED INTERVERTEBRAL DISK STABILIZER AND METHOD, which is hereby incorporated into this specification in its entirety by this specific reference thereto.

As shown in FIGS. 8 and 9, implant 122 also comprises a lock 124 which is substantially square when viewed from the end 140 along the axis of the bore 128 therethrough and U-shaped when viewed from the side. The inside surfaces 142 of the arms 144 of the U-shaped lock 124 are flat for contacting the first and second sides 132 of monolithic implant 122 to prevent rotation of lock 124 relative to implant 122 when lock 124 is mounted to implant 122 and secured thereto by bolt 126. The surfaces 142 are provided with a slot 146 for receiving a complementary-shaped key 148 (it will be recognized that the key 148 could be formed on the surfaces 142 and that slot 146 could be formed in the first and second sides 132 of implant 122) to facilitate assembly of lock 124 to implant 122 so that the bore 128 in lock 124 is aligned with the bore 130 in implant 122. The sides of the square end 140 of lock 124 provide surfaces 150 for bearing against the bodies 29 and 31 of the respective adjacent vertebrae 33 and 37 as explained below, but it will be recognized by those skilled in the art who have the benefit of this disclosure that the bearing surfaces 150 need not be flat and that the end 140 of lock 124 need not necessarily be square.

The monolithic implant 122 is inserted into the disk space from which the body 12 of the first apparatus 10 is removed on the end of an elongate applicator (not shown here but shown in detail in the above-referenced and incorporated co-pending application) which is provided with threads for mating with the threads in the bore 130 in implant 122. The disk space is then packed with cancellous bone chips (not shown). When the threaded end of the applicator is screwed all the way into the bore 130 so as to prevent relative movement of the implant 122 and its applicator, the monolithic implant 122 is then inserted into the disk space with the flat surfaces 132 adjacent the bodies 29 and 31 of adjacent vertebrae 33 and 37 and moved in an anterior-posterior direction so as to enable the implant 122 to be positioned in the disk space at a position in which the expanded, middle portion and the smaller width ends 125 and 136 of the third and fourth sides 134 of implant 122 contact the respective lower and upper surfaces of the bodies 29 and 31 of the adjacent vertebrae 33 and 37 when rotated by approximately 90° using the applicator. The respective lower and upper surfaces of the bodies 29 and 31 of vertebrae 33 and 37 are slightly concave such that the larger width middle portion W" of implant 122 allows the implant 122 to engage substantially more of the respective surfaces of the vertebral bodies 29 and 31 than conventional prosthetic devices, thereby providing increased stability to the fusion once increased stability to the fusion once further rotation of implant 122 in the disk space is prevented as described below.

Once positioned in the disk space so as to provide maximum stabilization, the applicator is then detached from the monolithic implant 122 by unscrewing and backed out of the incision in the patient. Lock 124 is then inserted through that same incision and, using the slot 146 and key 148, the bore 128 in lock 124 and bore 130 in implant 122 are aligned and the bolt 126 is inserted and tightened to secure lock 124 to the implant 122. Securing the lock 124 to implant 122 in this manner prevents relative rotation between lock 24 and implant 122. Because the bearing surfaces 150 of lock 124 bear against the bodies 29 and 31 of the respective adjacent vertebrae 33 and 37 to prevent rotation of the lock 124 relative to the adjacent vertebrae 33 and 37 against which the bearing surfaces 150 bear, rotation of the implant 122 in the disk space is prevented. Those skilled in the art who have the benefit of this disclosure will recognize that the bearing surfaces 150 bear against the cortical end plate of the bodies 29 and 31 of the respective adjacent vertebrae 33 and 37, which is comprised of non-cancellous bone, and provides a hard, relatively smooth surface against which the bearing surfaces 150 bear. The end 140 of lock 124 is preferably supplied in a plurality of different sizes and shapes other than the square shaped end 140 shown in the figures so as to allow the surgeon to select an appropriately sized and shaped lock which provides a close fit with the space between vertebral bodies. Once the monolithic implant 122 is locked in place on the first side of the center line of the adjacent vertebrae 33 and 37, the body 12 of the second apparatus 10 on the second side of the center line, which has remained in place throughout the procedure, is then removed. The disk space is then packed with cancellous bone chips through this second side and a second monolithic implant (also not shown) is inserted, positioned, rotated, and locked in its place in the same manner as described above.

If necessary, a small amount of a physiologically compatible adhesive of a type known in the art is applied over the cancellous bone chips just medial to the implants to close off the remaining portion of the openings into the disk space. The patient should be able to ambulate soon after the procedure because of the stability imparted to the spinal column by the implant of the present invention. Before narrowing of the disk space occurs, the cancellous bone chips will have started the fusion process.

Referring now to FIGS. 10 and 11, there is shown an alternative embodiment of the apparatus, indicated generally at reference numeral 10a, of the present invention. Where possible, the component parts of apparatus 10a are labelled with the reference numeral (and the "a" designation) of the corresponding parts of the apparatus 10. Apparatus 10a is comprised of a handle 11a and body 12a, the body 12a being comprised of first (fixed) and second (movable) members 13a and 14a, respectively. The second member 14a is mounted to a mandrel 17a positioned in a longitudinal bore 16a in the shaft 15a by a swivel joint 40a and moves relative to first member 13a by action of the threads 21a formed on the outside surface of mandrel 17a on the threads 20a formed on the shaft 15a of handle 11a. The body 12a of apparatus 10a is shaped in the same substantially rectangular cross-sectional shape as the body 12 of apparatus 10 and the component parts of apparatus 10a function in the same manner as the parts of apparatus 10.

Apparatus 10a also includes a plurality of fine serrations 42a formed on the opposed surfaces 44a and 46a of first and second members 13a and 14a, respectively. The serrations 42a act to resist longitudinal movement of second member 14a relative to first member 13a.

Although described in terms of the preferred embodiment shown in the figures, this embodiment is shown to exemplify the present invention, it being recognized by those skilled in the art that certain changes can be made to the specific structure of the preferred embodiment shown and described without departing from the spirit of the present invention. All such modifications are intended to fall within the scope of the following claims.

Pisharodi, Madhavan

Patent Priority Assignee Title
10039585, Jun 17 2003 DEPUY SYNTHES PRODUCTS, INC Methods, materials and apparatus for treating bone and other tissue
10058433, Jul 26 2012 DePuy Synthes Products, Inc. Expandable implant
10085843, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
10105239, Feb 14 2013 Globus Medical, Inc Devices and methods for correcting vertebral misalignment
10111697, Sep 26 2003 DePuy Synthes Products, Inc. Device for delivering viscous material
10117754, Feb 25 2013 Globus Medical, Inc Expandable intervertebral implant
10123829, Jun 15 2015 NuVasive, Inc Reduction instruments and methods
10159582, Sep 16 2011 DePuy Synthes Products, Inc. Removable, bone-securing cover plate for intervertebral fusion cage
10238500, Jun 27 2002 DePuy Synthes Products, Inc. Intervertebral disc
10272174, Sep 14 2006 DEPUY SYNTHES PRODUCTS, INC Bone cement and methods of use thereof
10327911, Jun 24 2010 DePuy Synthes Products, Inc. Enhanced cage insertion assembly
10369015, Sep 23 2010 DEPUY SYNTHES PRODUCTS, INC Implant inserter having a laterally-extending dovetail engagement feature
10376372, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
10390963, Dec 07 2006 DePuy Synthes Products, Inc. Intervertebral implant
10398563, May 08 2017 MEDOS INTERNATIONAL SARL Expandable cage
10398566, Dec 07 2006 DePuy Synthes Products, Inc. Intervertebral implant
10405986, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
10420651, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
10433881, Mar 06 2004 DePuy Synthes Products, Inc. Dynamized interspinal implant
10433971, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
10433974, Jun 30 2003 DePuy Synthes Products, Inc. Intervertebral implant with conformable endplate
10433977, Jan 17 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant and associated method of manufacturing the same
10449056, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
10449058, Jan 17 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant and associated method of manufacturing the same
10485597, Mar 31 2003 DEPUY SYNTHES PRODUCTS, INC Remotely-activated vertebroplasty injection device
10492918, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
10494158, Oct 19 2006 DePuy Synthes Products, Inc. Fluid delivery system
10500062, Dec 10 2009 DePuy Synthes Products, Inc. Bellows-like expandable interbody fusion cage
10512489, Mar 06 2004 DePuy Synthes Products, Inc. Dynamized interspinal implant
10537436, Nov 01 2016 DEPUY SYNTHES PRODUCTS, INC Curved expandable cage
10548741, Jun 29 2010 DePuy Synthes Products, Inc. Distractible intervertebral implant
10555817, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
10575959, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
10583013, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
10583015, Dec 07 2006 DePuy Synthes Products, Inc. Intervertebral implant
10624758, Mar 30 2009 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
10631906, Nov 22 2005 DePuy Synthes Products, Inc. Apparatus for transferring a viscous material
10639164, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
10743921, Jun 15 2015 NuVasive, Inc. Reduction instruments and methods
10786361, Feb 14 2003 DEPUY SYNTHES PRODUCTS, INC In-situ formed intervertebral fusion device and method
10799278, Mar 14 2003 DePuy Synthes Products, Inc. Hydraulic device for the injection of bone cement in percutaneous vertebroplasty
10813773, Sep 16 2011 DePuy Synthes Products, Inc. Removable, bone-securing cover plate for intervertebral fusion cage
10856997, Feb 22 2018 Warsaw Orthopedic, Inc Expandable spinal implant system and method of using same
10881520, Dec 23 2005 DePuy Synthes Products, Inc. Flexible elongated chain implant and method of supporting body tissue with same
10888433, Dec 14 2016 DEPUY SYNTHES PRODUCTS, INC Intervertebral implant inserter and related methods
10940016, Jul 05 2017 DEPUY SYNTHES PRODUCTS, INC; MEDOS INTERNATIONAL SARL Expandable intervertebral fusion cage
10966840, Jun 24 2010 DePuy Synthes Products, Inc. Enhanced cage insertion assembly
10973652, Jun 26 2007 DePuy Synthes Products, Inc. Highly lordosed fusion cage
11020239, Feb 22 2018 Warsaw Orthopedic, Inc Expandable spinal implant system and method of using same
11026806, Dec 07 2006 DePuy Synthes Products, Inc. Intervertebral implant
11096794, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
11207187, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
11273050, Dec 07 2006 DePuy Synthes Products, Inc. Intervertebral implant
11285014, Nov 05 2020 Warsaw Orthopedic, Inc. Expandable inter-body device, system, and method
11291554, May 03 2021 Medtronic, Inc. Unibody dual expanding interbody implant
11311391, Nov 05 2020 Warsaw Orthopedic, Inc. Dual expanding spinal implant, system, and method of use
11344424, Jun 14 2017 MEDOS INTERNATIONAL SARL Expandable intervertebral implant and related methods
11376134, Nov 05 2020 Warsaw Orthopedic, Inc. Dual expanding spinal implant, system, and method of use
11395743, May 04 2021 Warsaw Orthopedic, Inc Externally driven expandable interbody and related methods
11406508, Dec 23 2005 DePuy Synthes Products, Inc. Flexible elongated chain implant and method of supporting body tissue with same
11426286, Mar 06 2020 EIT Emerging Implant Technologies GmbH Expandable intervertebral implant
11426290, Mar 06 2015 SYNTHES USA PRODUCTS, LLC; DEPUY SYNTHES PRODUCTS, INC Expandable intervertebral implant, system, kit and method
11432938, Feb 14 2003 DEPUY SYNTHES PRODUCTS, INC In-situ intervertebral fusion device and method
11432942, Dec 07 2006 DEPUY SYNTHES PRODUCTS, INC Intervertebral implant
11446155, May 08 2017 MEDOS INTERNATIONAL SARL Expandable cage
11446156, Oct 25 2018 MEDOS INTERNATIONAL SARL Expandable intervertebral implant, inserter instrument, and related methods
11452607, Oct 11 2010 DePuy Synthes Products, Inc. Expandable interspinous process spacer implant
11452609, Mar 30 2009 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
11497618, Dec 07 2006 DePuy Synthes Products, Inc. Intervertebral implant
11497619, Mar 07 2013 DePuy Synthes Products, Inc. Intervertebral implant
11510788, Jun 28 2016 EIT Emerging Implant Technologies GmbH Expandable, angularly adjustable intervertebral cages
11517443, Dec 16 2020 Warsaw Orthopedic, Inc.; Warsaw Orthopedic, Inc Dual wedge expandable implant, system and method of use
11547577, Feb 14 2013 Globus Medical Inc. Devices and methods for correcting vertebral misalignment
11564724, Nov 05 2020 Warsaw Orthopedic, Inc. Expandable inter-body device, system and method
11583415, Jun 24 2021 Warsaw Orthopedic, Inc. Expandable interbody implant
11596522, Jun 28 2016 EIT Emerging Implant Technologies GmbH Expandable and angularly adjustable intervertebral cages with articulating joint
11596523, Jun 28 2016 EIT Emerging Implant Technologies GmbH Expandable and angularly adjustable articulating intervertebral cages
11602438, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
11607321, Dec 10 2009 DePuy Synthes Products, Inc. Bellows-like expandable interbody fusion cage
11612491, Mar 30 2009 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
11612493, Jun 30 2003 DePuy Synthes Products, Inc. Intervertebral implant with conformable endplate
11612499, Jun 24 2021 Warsaw Orthopedic, Inc. Expandable interbody implant
11617655, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
11617658, Nov 05 2020 Warsaw Orthopedic, Inc. Expandable inter-body device, system and method
11622868, Jun 26 2007 DePuy Synthes Products, Inc. Highly lordosed fusion cage
11638653, Nov 05 2020 Warsaw Orthopedic, Inc. Surgery instruments with a movable handle
11642229, Dec 07 2006 DePuy Synthes Products, Inc. Intervertebral implant
11654033, Jun 29 2010 DePuy Synthes Products, Inc. Distractible intervertebral implant
11660206, Dec 07 2006 DePuy Synthes Products, Inc. Intervertebral implant
11690657, Jun 15 2015 NuVasive, Inc. Reduction instruments and methods
11701233, Dec 23 2005 DePuy Synthes Products, Inc. Flexible elongated chain implant and method of supporting body tissue with same
11701234, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
11707359, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
11712341, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
11712342, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
11712345, Dec 07 2006 DePuy Synthes Products, Inc. Intervertebral implant
11730608, Jul 13 2021 Warsaw Orthopedic, Inc. Monoblock expandable interbody implant
11737881, Jan 17 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant and associated method of manufacturing the same
11752005, Feb 22 2018 Warsaw Orthopedic, Inc. Expandable spinal implant system and method of using same
11752009, Apr 06 2021 MEDOS INTERNATIONAL SARL Expandable intervertebral fusion cage
11806245, Mar 06 2020 EIT Emerging Implant Technologies GmbH Expandable intervertebral implant
11806250, Feb 22 2018 Warsaw Orthopedic, Inc. Expandable spinal implant system and method of using same
11833059, Nov 05 2020 Warsaw Orthopedic, Inc. Expandable inter-body device, expandable plate system, and associated methods
11850160, Mar 26 2021 MEDOS INTERNATIONAL SARL Expandable lordotic intervertebral fusion cage
11850163, Feb 01 2022 Warsaw Orthopedic, Inc. Interbody implant with adjusting shims
11850164, Mar 07 2013 DePuy Synthes Products, Inc. Intervertebral implant
11872139, Jun 24 2010 DePuy Synthes Products, Inc. Enhanced cage insertion assembly
11911287, Jun 24 2010 DePuy Synthes Products, Inc. Lateral spondylolisthesis reduction cage
5928243, Jul 16 1997 ZIMMER SPINE, INC Pedicle probe and depth gage
5935133, Aug 26 1997 ZIMMER SPINE, INC Surgical cable system and method
5964769, Aug 26 1997 ZIMMER SPINE, INC Surgical cable system and method
5989250, Oct 01 1997 ZIMMER SPINE, INC Method and apparatus for spinal fixation
6030389, Jun 02 1998 ZIMMER SPINE, INC System and method for stabilizing the human spine with a bone plate
6045579, May 01 1997 ZIMMER SPINE, INC Adjustable height fusion device
6053921, Aug 26 1997 ZIMMER SPINE, INC Surgical cable system and method
6080193, May 01 1997 ZIMMER SPINE, INC Adjustable height fusion device
6132430, Oct 24 1996 ZIMMER SPINE, INC Spinal fixation system
6159212, Aug 02 1999 Surgical tool and method to reduce vertebral displacement
6391030, Aug 26 1997 ZIMMER SPINE, INC Surgical cable system and method
6416515, Oct 24 1996 ZIMMER SPINE, INC Spinal fixation system
6447512, Jan 06 2000 ZIMMER SPINE, INC Instrument and method for implanting an interbody fusion device
6454769, Aug 04 1997 ZIMMER SPINE, INC System and method for stabilizing the human spine with a bone plate
6491695, Nov 05 1999 Apparatus and method for aligning vertebrae
6524312, Jan 06 2000 ZIMMER SPINE, INC Instrument and method for implanting an interbody fusion device
6557226, Apr 23 1999 ZIMMER SPINE, INC Apparatus for manufacturing a bone dowel
6562040, Oct 24 1996 ZIMMER SPINE, INC Spinal fixation system
6569168, May 05 2000 Warsaw Orthopedic, Inc Intervertebral distractor and implant insertion instrument
6576016, May 01 1997 ZIMMER SPINE, INC Adjustable height fusion device
6595992, Oct 24 1996 ZIMMER SPINE, INC Method and apparatus for spinal fixation
6613050, Oct 24 1996 ZIMMER SPINE, INC Method and apparatus for spinal fixation
6616671, Jan 06 2000 ZIMMER SPINE, INC Instrument and method for implanting an interbody fusion device
6682533, Aug 26 1997 ZIMMER SPINE, INC Surgical cable system and method
6709438, Aug 10 2000 Altus Partners, LLC Cam action vertebral spreader
6730125, Feb 02 2000 Spinal fixation and retrieval device having side pieces
6964664, Jan 06 2000 ZIMMER SPINE, INC System and method for stabilizing the human spine with a bone plate
6966929, Oct 29 2002 Kyphon SARL Artificial vertebral disk replacement implant with a spacer
7083649, Oct 29 2002 Kyphon SARL Artificial vertebral disk replacement implant with translating pivot point
7097648, Jan 27 1999 Kyphon SARL Expandable element delivery system
7169183, Sep 12 2002 Warsaw Orthopedic, Inc Vertebral implant for promoting arthrodesis of the spine
7267692, Sep 14 2001 Nucleus prosthesis, the insertion device therefor and the method of fitting same
7273496, Oct 29 2002 Kyphon SARL Artificial vertebral disk replacement implant with crossbar spacer and method
7320707, Nov 05 2003 Kyphon SARL Method of laterally inserting an artificial vertebral disk replacement implant with crossbar spacer
7452379, Oct 29 2002 Kyphon SARL Artificial vertebral disk replacement implant with crossbar spacer and method
7465305, Aug 26 1997 Warsaw Orthopedic, Inc. Spinal implant and cutting tool preparation accessory for mounting the implant
7481839, Dec 02 2003 MEDTRONIC EUROPE SARL Bioresorbable interspinous process implant for use with intervertebral disk remediation or replacement implants and procedures
7481840, Sep 29 2004 Kyphon SARL Multi-piece artificial spinal disk replacement device with selectably positioning articulating element
7497859, Oct 29 2002 Kyphon SARL Tools for implanting an artificial vertebral disk
7503935, Dec 02 2003 Kyphon SARL Method of laterally inserting an artificial vertebral disk replacement with translating pivot point
7520899, Nov 05 2003 Kyphon SARL Laterally insertable artificial vertebral disk replacement implant with crossbar spacer
7575600, Sep 29 2004 Kyphon SARL Artificial vertebral disk replacement implant with translating articulation contact surface and method
7597694, Jan 30 2004 Warsaw Orthopedic, Inc Instruments and methods for minimally invasive spinal stabilization
7621950, Jan 27 1999 Kyphon SARL Expandable intervertebral spacer
7621958, Mar 27 1995 Warsaw Orthopedic, Inc. Methods and instruments for interbody fusion
7625380, Jul 21 2004 Warsaw Orthopedic, Inc Dual distractor inserter
7637952, Mar 11 2002 ZIMMER BIOMET SPINE, INC Instrumentation and procedure for implanting spinal implant devices
7670377, Nov 21 2003 Kyphon SARL Laterally insertable artifical vertebral disk replacement implant with curved spacer
7691146, Nov 21 2003 Kyphon SARL Method of laterally inserting an artificial vertebral disk replacement implant with curved spacer
7766947, Oct 31 2001 Ortho Development Corporation Cervical plate for stabilizing the human spine
7815664, Jan 04 2005 Warsaw Orthopedic, Inc Systems and methods for spinal stabilization with flexible elements
7909878, Oct 26 2004 Artificial spinal disc, insertion tool, and method of insertion
7918855, Dec 14 2000 Warsaw Orthopedic, Inc. Spinal interspace shaper
7976549, Mar 23 2006 Theken Spine, LLC Instruments for delivering spinal implants
7985258, Mar 27 1995 Warsaw Orthopedic Inc. Methods and instruments for interbody fusion
7988695, Dec 21 2005 Theken Spine, LLC Articulated delivery instrument
8002804, Jan 30 2004 Warsaw Orthopedic, Inc. Instruments and methods for minimally invasive spinal stabilization
8025677, Jan 06 2000 ZIMMER BIOMET SPINE, INC System and method for stabilizing the human spine with a bone plate
8029548, May 05 2008 Warsaw Orthopedic, Inc. Flexible spinal stabilization element and system
8066707, Jun 09 1999 Warsaw Orthopedic, Inc Method for preparing a space in bone to receive an insert
8066713, Mar 31 2003 Depuy Synthes Products, LLC Remotely-activated vertebroplasty injection device
8080061, Jun 20 2005 Synthes USA, LLC Apparatus and methods for treating bone
8110005, Apr 10 2000 Biomet Manufacturing, LLC Modular prosthesis and use thereof for replacing a radial head
8114163, Apr 09 2001 Biomet Manufacturing, LLC Method and apparatus for adjusting height and angle for a radial head
8317794, Jun 09 1999 Warsaw Orthopedic, Inc. Device for preparing a space in bone to receive an insert
8333773, Mar 31 2003 Depuy Synthes Products, LLC Remotely-activated vertebroplasty injection device
8360629, Nov 22 2005 Depuy Synthes Products, LLC Mixing apparatus having central and planetary mixing elements
8361078, Jun 17 2003 Depuy Synthes Products, LLC Methods, materials and apparatus for treating bone and other tissue
8366781, Apr 10 2000 Biomet Manufacturing, LLC Modular prosthesis and use thereof for replacing a radial head
8377063, Dec 14 2000 Warsaw Orthopedic, Inc. Method for preparing a space in the human spine
8414620, Jan 04 2005 Warsaw Orthopedic, Inc. Systems and methods for spinal stabilization with flexible elements
8415407, Jul 30 2004 Depuy Synthes Products, LLC Methods, materials, and apparatus for treating bone and other tissue
8425615, Apr 10 2000 Biomet Manufacturing, LLC Method and apparatus for adjusting height and angle for a radial head
8480715, May 22 2007 ZIMMER SPINE, INC Spinal implant system and method
8506636, Sep 08 2006 Theken Spine, LLC Offset radius lordosis
8535382, Apr 10 2000 Biomet Manufacturing, LLC Modular radial head prostheses
8540722, Jun 17 2003 Depuy Synthes Products, LLC Methods, materials and apparatus for treating bone and other tissue
8579908, Sep 26 2003 Depuy Synthes Products, LLC Device for delivering viscous material
8623091, Jun 29 2010 DEPUY SYNTHES PRODUCTS, INC Distractible intervertebral implant
8728160, Jan 27 1999 Kyphon SARL Expandable intervertebral spacer
8740943, Jan 02 1997 Warsaw Orthopedic, Inc. Spine distraction implant and method
8809418, Mar 21 2004 Depuy Synthes Products, LLC Methods, materials and apparatus for treating bone and other tissue
8888817, Jan 04 2005 Warsaw Orthopedic, Inc. Systems and methods for spinal stabilization with flexible elements
8920509, Apr 10 2000 Biomet Manufacturing, LLC Modular radial head prosthesis
8950929, Oct 19 2006 Depuy Synthes Products, LLC Fluid delivery system
8956368, Jun 17 2003 Depuy Synthes Products, LLC Methods, materials and apparatus for treating bone and other tissue
8992541, Mar 14 2003 Depuy Synthes Products, LLC Hydraulic device for the injection of bone cement in percutaneous vertebroplasty
9034045, Mar 15 2013 Globus Medical, Inc Expandable intervertebral implant
9149367, Mar 15 2013 Globus Medical, Inc Expandable intervertebral implant
9186194, Mar 14 2003 DePuy Synthes Products, Inc. Hydraulic device for the injection of bone cement in percutaneous vertebroplasty
9186258, Mar 15 2013 Globus Medical, Inc Expandable intervertebral implant
9198771, May 12 2011 LFC SPOLKA Z O O Intervertebral implant for mutual situating of adjacent vertebrae
9204972, Mar 01 2013 Globus Medical, Inc Articulating expandable intervertebral implant
9259696, Nov 22 2005 DEPUY SYNTHES PRODUCTS, INC Mixing apparatus having central and planetary mixing elements
9289240, Dec 23 2005 Depuy Synthes Products, LLC Flexible elongated chain implant and method of supporting body tissue with same
9295562, Jan 17 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant and associated method of manufacturing the same
9320615, Jun 29 2010 DEPUY SYNTHES PRODUCTS, INC Distractible intervertebral implant
9333084, Apr 10 2000 Biomet Manufacturing, LLC Modular prosthesis and use thereof for replacing a radial head
9351848, Sep 03 2010 Globus Medical, Inc Expandable fusion device and method of installation thereof
9381024, Jul 31 2005 DEPUY SYNTHES PRODUCTS, INC Marked tools
9402737, Jun 26 2007 DePuy Synthes Products, Inc. Highly lordosed fusion cage
9402738, Feb 14 2013 Globus Medical, Inc Devices and methods for correcting vertebral misalignment
9402739, Feb 07 2014 Globus Medical, Inc Variable lordosis spacer and related methods of use
9414934, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
9433510, Jan 17 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant and associated method of manufacturing the same
9439784, Apr 10 2000 Biomet Manufacturing, LLC Modular radial head prosthesis
9474623, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
9504508, Jun 17 2003 DePuy Synthes Products, Inc. Methods, materials and apparatus for treating bone and other tissue
9526620, Mar 30 2009 DEPUY SYNTHES PRODUCTS, INC Zero profile spinal fusion cage
9526625, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
9545314, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
9561117, Jul 26 2012 DePuy Synthes Products, Inc. Expandable implant
9566168, Sep 03 2010 Globus Medical, Inc Expandable fusion device and method of installation thereof
9579208, Apr 10 2000 Biomet Manufacturing, LLC Modular radial head prosthesis
9579215, Jun 29 2010 DePuy Synthes Products, Inc. Distractible intervertebral implant
9585765, Feb 14 2013 Globus Medical, Inc Devices and methods for correcting vertebral misalignment
9592129, Mar 30 2009 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
9597195, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
9642932, Sep 14 2006 DEPUY SYNTHES PRODUCTS, INC Bone cement and methods of use thereof
9717601, Feb 28 2013 DEPUY SYNTHES PRODUCTS, INC Expandable intervertebral implant, system, kit and method
9724207, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
9750552, Jul 06 2009 DePuy Synthes Products, Inc. Expandable fixation assemblies
9750840, Mar 21 2004 DePuy Synthes Products, Inc. Methods, materials and apparatus for treating bone and other tissue
9782265, Feb 15 2013 Globus Medical, Inc Articulating and expandable vertebral implant
9788963, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
9801729, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
9808351, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
9814589, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
9814590, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
9833334, Jun 24 2010 DePuy Synthes Products, Inc. Enhanced cage insertion assembly
9839460, Mar 31 2003 DEPUY SYNTHES PRODUCTS, INC Remotely-activated vertebroplasty injection device
9839530, Jun 26 2007 DePuy Synthes Products, Inc. Highly lordosed fusion cage
9895236, Jun 24 2010 DePuy Synthes Products, Inc. Enhanced cage insertion assembly
9913727, Jul 02 2015 MEDOS INTERNATIONAL SARL Expandable implant
9918767, Aug 01 2005 DEPUY SYNTHES PRODUCTS, INC Temperature control system
9925060, Feb 14 2003 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
9931223, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
9949769, Mar 06 2004 DePuy Synthes Products, Inc. Dynamized interspinal implant
9956085, Dec 23 2005 DePuy Synthes Products, Inc. Flexible elongated chain implant and method of supporting body tissue with same
9993349, Jun 27 2002 DEPUY SYNTHES PRODUCTS, INC Intervertebral disc
9993350, Apr 05 2008 DePuy Synthes Products, Inc. Expandable intervertebral implant
D948048, Apr 26 2019 Warsaw Orthopedic, Inc Surgical implant
D955579, Apr 26 2019 Warsaw Orthopedic, Inc Surgical implant
D957639, Mar 11 2014 Medtronic, Inc Implantable cardiac monitor
ER1479,
ER4289,
ER579,
ER9751,
RE47427, Jan 27 1999 MEDTRONIC HOLDING COMPANY SÀRL Expandable intervertebral spacer
Patent Priority Assignee Title
4696290, Dec 16 1983 DEPUY ACROMED, INC Apparatus for straightening spinal columns
4714469, Feb 26 1987 PFIZER HOSPITAL PRODUCTS GROUP, INC Spinal implant
5015247, Jun 13 1988 Warsaw Orthopedic, Inc Threaded spinal implant
5059193, Nov 20 1989 ZIMMER SPINE, INC Expandable spinal implant and surgical method
5425773, Apr 05 1994 SDGI Holdings, Inc Intervertebral disk arthroplasty device
5431658, Feb 14 1994 Facilitator for vertebrae grafts and prostheses
5443514, Oct 01 1993 DEPUY ACROMED, INC Method for using spinal implants
5454365, Nov 05 1990 BONUTTI 2003 TRUST-A, THE Mechanically expandable arthroscopic retractors
EP42271,
Executed onAssignorAssigneeConveyanceFrameReelDoc
Date Maintenance Fee Events
Apr 11 2001ASPN: Payor Number Assigned.
Jun 04 2001M283: Payment of Maintenance Fee, 4th Yr, Small Entity.
Jun 12 2001RMPN: Payer Number De-assigned.
Apr 22 2005M2552: Payment of Maintenance Fee, 8th Yr, Small Entity.
Jun 22 2009REM: Maintenance Fee Reminder Mailed.
Dec 16 2009EXP: Patent Expired for Failure to Pay Maintenance Fees.


Date Maintenance Schedule
Dec 16 20004 years fee payment window open
Jun 16 20016 months grace period start (w surcharge)
Dec 16 2001patent expiry (for year 4)
Dec 16 20032 years to revive unintentionally abandoned end. (for year 4)
Dec 16 20048 years fee payment window open
Jun 16 20056 months grace period start (w surcharge)
Dec 16 2005patent expiry (for year 8)
Dec 16 20072 years to revive unintentionally abandoned end. (for year 8)
Dec 16 200812 years fee payment window open
Jun 16 20096 months grace period start (w surcharge)
Dec 16 2009patent expiry (for year 12)
Dec 16 20112 years to revive unintentionally abandoned end. (for year 12)